Be Good to Yourself: Holiday Anxiety & Depression

’Tis the season to be jolly…unless you’re not. For many people, the holidays are not the most joyous time of the year. In fact, the pressure to be happy all the time only adds to the feelings of isolation, anxiety and sadness that can overcome some people this time of year.

One reason the holidays may be a difficult time involves the changing seasons, explains Dr. Duru Sakhrani, a psychiatrist with Mercy St. Louis. “There’s a component called seasonal affective disorder (SAD) that we see right around the holidays,” she says. “And the very intense time of the holidays just increases stress and anxiety. If there is true depression or situation depression, it can be heightened. So the holiday blues can be part of a bigger picture of seasonal affective disorder.”

Scientists theorize that SAD has to do with decreased exposure to sunlight during the winter months. Symptoms include classic depressive traits such as sadness, pessimism, irritability, fatigue, difficulty concentrating and changes in sleep patterns. People diagnosed with SAD are often treated with antidepressants and/or light therapy, which involves exposure to simulated sunlight.

“People who have comorbid psychiatric issues, such as anxiety, can definitely worsen at this time of year,” Sakhrani says. “And around this time, there is cultural pressure around substances like alcohol, which flows freely at holiday parties. Consumption of these substances can aggravate an already fragile situation.”

Although some people tend to dismiss seasonal depression, recognizing what marks true clinical depression is important, says psychiatrist Dr. Pearl Serota. “Clinical depression differs from ‘the blues’ in several important respects: duration of symptoms, severity of symptoms and number of symptoms can distinguish the blues from a true clinical depression,” she says.

Serota adds that in order to meet criteria for a major depression, a person must have five or more symptoms of depression, including changes in sleep (increased or decreased), appetite (increased or decreased), energy level, concentration, decreased mood, and decrease in interests and enjoyment in things that used to bring pleasure. “However, the symptoms that most distinguish the blues from a true depression are feelings of worthlessness, helplessness and hopelessness, as well as preoccupation with death and suicidal thoughts.”

Both Serota and Sakhrani emphasize that these symptoms should not be ignored. “Everyone has occasional down days or ‘the blues,’ but if symptoms of (true depression) persist for more than a couple of weeks, it is important to seek help from a mental health practitioner,” Serota says.

Strategies to avoid holiday depression largely involve maintaining routine and self-care. For instance, Sakhrani advises special attention to continuing healthy eating and regular exercise routines. Physical activity is known to help improve mood and enhance immunity, helping to avoid seasonal illnesses that can cause schedule upsets during the holidays. She also stresses the importance of sleep, pointing out the benefits of maintaining regular sleep and wake cycles.

Relax, be good to yourself, and don’t force yourself into the ‘holiday spirit.’ Take the time to enjoy little things that bring pleasure, and get help if you or a loved one can’t shake the holiday blues.